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Re: Fluoride - Demand AARP Take Action

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Message 1281 of 1,417

Dr. Johnny Johnson,

 

Before I respond to your comments, let me once again express my admiration for Pedodontists.  I worked in a rural area where there were no specialists and I took children to the hospital for treatment.  Moving on to a larger center, the first thing I did was find a good Pedodontist to take my children.  

 

Adults usually know why they have problems and accept treatment.  Children don't understand and too often suffer with fear, pain, and the unknown.  I hurt for the kids and was just as stressed as they.  I would not have lasted long drilling holes in children.  God bless Pedodontists.  And yes, I gave the kids fluoride before I knew it was frying their thyroids and brains.

 

Yes, I treat dental fluorosis.  Some try bleaching, which can have some benefit.  Some try smoothing and recalcification, but they don't follow through well.  Some want composite veneers and some porcelain veneers.

 

Johnny, those (CPSTF and others) who say that severe fluorosis does not occur with CWF. . . make no sense and have their heads buried in the sand.

 

CWF is a contributing factor for total fluoride exposure.   No one has done a study on humans removing all other sources of fluoride.  Humans don't consume ONLY CWF water and no foods, medications, dental products or any other sources of fluoride.  CPSTF is probably correct, if the only intake of fluoride were CWF, the person would die from lack of food and air. . . never developing DF.  Many sources of fluoride and we don't live in isolation living on CWF alone.

 

The statement is not real world, reality, and is theoretical abstract non-sense.  

 

CWF contributes to total fluoride exposure.  

 

My concern is TOTAL FLUORIDE EXPOSURE.  

 

20% of adolescents have moderate/severe DF.  When CWF started, Burk assured us perhaps only 10-15% of children would get DF and then only the mildest forms.   We now have 60% with 20% moderate/severe.  In my judgment, too many children are ingesting too much fluoride.

 

As a public health professional, it is urgent that we reduce total fluoride exposure.  Do we do that by removing fluoride medications, pesticides, post-harvest fumigants, or ??????   Clearly, adding more fluoride to the diet with CWF is the most reasonable step to reduce exposure.  In fact, HHS agreed, lowering the concentration to 0.7 ppm.   They estimated a 14% reduction in exposure.  A great start, but not enough.   Getting the CWF to 0.4 ppm would still not be enough.  We need a cessation of CWF AND also determine where additional fluoride is coming from or is the DF a synergistic effect from other chemicals?

 

CDC needs to release the data on the next two dental fluorosis surveys after 2011-2012 NHANES.  Yes, they have done two more and have released the data on everything except DF.   Why????  Why not release all the data ASAP?   

 

How many of the USCPSTF members have reservations about CWF?  No, the members were cherry picked for their support of CWF.  Because of their belief in CWF, they did not demand high quality evidence.  Cochrane reviews are better/higher quality.

 

You suggest my comments are mixing facts and snippets, but I can say the same for your comments.    

 

Indeed, some evidence is stronger than others.  Each needs to be weighed and the weight of each added for a judgment.

 

1.   Many are ingesting too much fluoride.

 

2.  Stopping CWF will still not reduce total exposure enough to get DF under control.

 

3.  The evidence for efficacy of ingesting fluoride is not adequate to gain FDA approval.  Ingesting fluoride may not work, topical has some benefit.

 

4.  The evidence of risk is ever increasing and rapidly now that researchers know how to focus their research to areas of concern.  

 

Question Johnny,  "What concentration of fluoride in the tooth is optimal?"  Teeth with caries and without caries have similar concentrations of fluoride, except for topical application on the surface of the tooth.

 

Bill Osmunson DDS MPH

 

Document5-001.jpg

 

 

 

 

 

 

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Message 1282 of 1,417

So, okay, Bill, you claim the CDC/NHANES data used for the graph to be “bogus, an exageration and simply cherry picked science.” and that “they [CDC] persist in telling lies.”  in regard to the inverse relation of fluoridation and dental decay incidence depicted in the graph.....yet you seem to have no probem with NHANES data when you believe it supports some point you deem important about dental fluorosis.   Hmm.....there seems to be a bit of confirmation bias occurring in your thinking.

 

As you, yourself, noted, the NRC Committee on Fluoride in Drinking Water considered only the severe level of dental fluorosis to be an adverse effect.  As far as your patient whom you claim wants treatment for moderate or mild dental fluorosis, in all likelihood, any perception of “harm” and request for treatment would be driven by your own bias and recommendations to the patient, not by an initial complaint or desire of  that patient.  Peer-reviewed science has demonstrated such fluorosis to have little or no negative impact on oral health related quality of life of patients or their families.

 

“Using a population- and person-centered perspective, we conclude that dental caries in school-aged children in North Carolina is a much bigger public health concern than enamel fluorosis.  The prevalence of fluorosis is less than caries, and it had no impact on the OHRQoL of children or their families. Dental car-
ies had a negative impact on OHRQoL for the majority of students and their families.”

 

—Effects of Enamel Fluorosis and  Dental Caries on Quality of Life

U. Onoriobe, R.G. Rozier, J. Cantrell, and R.S. King

J Dent Res 93(10):972-979, 2014

 

Your personal bias, perception of what you personally deem to be “harm”, and treatment recommendations you make to your patients based on your own perceptions, are not valid reasons to deprive entire populations of the very valuable disease preventive benefits of water fluoridation......especially in view of the fact that the alternative to fluoridation is risk of significant increase in dental decay, which does, indeed have a negative impact on quality of life.

 

Steven D. Slott, DDS

 

 

 

 

 

 

 

 

 

 

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Message 1283 of 1,417

Steve,

You asked for references for the CDC Figure 1.  Note the CDC has 5 references for their data.

 

And you said only "severe" dental fluorosis is an adverse affect.  And if a patient comes in and wants treatment for moderate or mild DF, am I supposed to say they have a monosymptomatic hypochdriacal psycosis and send them out the door?  

 

Harm is in the eye of the beholder.  If I scratch your car, the car will run just fine and I'm sure you would not call that severe damage, so it is only cosmetic and does not need to be repaired, right?   Wrong.  If I scratched your car, it is harm.

 

Bill Osmunson DDS MPH

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1284 of 1,417

“CaryAnne”

 

Yes, all seniors need to do is observe how much “stain” they have noted on their grandkids’ teeth.  In doing so, they will note very little discernible discoloration which can in any manner, be attributable to fluoride exposure.  Why?  Because dental fluorosis is not a problem in regard to optimally fluoridated water, and is certainly not a problem that antifluoridationists have attempted to pump it into being.  The only dental fluorisis considered to be an adverse effect is severe.  This level of dental fluorosis is rare in the US, and does not occur in communities with a water fluoride content less than 2.0 ppm.  Water is fluoridated at 0.7 ppm, one third that level.  

 

Steven D. Slott, DDS

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Message 1285 of 1,417

"The continued increase in fluorosis rates in the U.S. indicates that additional measures need to be implemented to reduce its prevalence.” - Wiener et al. (2018)

 

Apologies to the senior citizens who must be disgusted by now with all the scientific vitriol since Thursday. However, since JJ brought up dental fluorosis and used a picture, I thought I'd share a picture - with excerpts from studies and citations for those of you who have noticed stains on your grand-kid's teeth, albeit more prevalent and with worse severity in Black & Hispanic populations because of a genetically determined lower tolerance to fluoride.

 

What has changed over the years is more and more communities are fluoridated. Dental fluorosis is a lagging indicator of overexposure from 10-12 years earlier, a predictor of increased learning disabilities during childhood, and a leading indicator of increased dental bills - for a lifetime.

 

DFwQuotes.jpgTo confirm the numbers, here are links to the source documents: 

2010 CDC: https://www.cdc.gov/nchs/data/databriefs/db53.pdf  
2018 31% increase in a decade: http://jdh.adha.org/content/92/1/23

 

BTW: My little daughter (white) who consumed fluoridated tap water from age one to age 3 had mild dental fluorosis on several of her teeth, diagnosed by her dentist who was positively gleeful when he saw it. I was not happy with those white stains. Since I figured out that it was the water causing rashes and stomach problems in both my children and myself, I switched to bottled water for a decade and my children's adult teeth were fine.

 

However, when I started using a filter about 10 years later, all sorts of other health effects emerged in my family. Sadly, I did not connect them to the water until after decades of misery. 

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Re: Fluoride - Demand AARP Take Action

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Message 1286 of 1,417

Bill, given that the graph you posted claiming to be something from the CDC, has no citation to its original location, and no context, whatoever, how you expect any valid conclusion to be drawn from such “information” based solely on your unsubstantiated personal assertion of what you deem to be shown in this graph....is anybody’s guess.

 

You need to learn what constitutes properly cited, valid scientific evidence.  Your reliance upon such nonsense as you post is probably one good reason why you have so little understanding of this issue, and can provide no valid evidence to supprt your claims.

 

Steven D. Slott, DDS

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Message 1287 of 1,417

Bill, I notice that as antifluoridationists become more and more frustrated with the facts and evidence presented debunking their claims, they begin making inane personal comments and project their own personality traits unto the commenters who are  frustrating them.  If you need anger management courses, that’s your business, but try not to project your problems unto me.....okay?

 

Your unsubstantiated personal opinions on the peer-reviewed scientific evidence you have requested, and which I have provided, is unqualified and obviously of no relevance.  What value you seem to believe there to be to some uncited graphs of something or other will remain a mystery known only to you, I suppose.

 

The bottom line is that I can and do provide valid scientific evidence to support my claims.  You cannot, and do not, for your own.

 

Steven D. Slott, DDS

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1288 of 1,417

Bill, I can’t even hazard a guess as to what you deem to be  the relevance of European dental amalgam to the public health initiative of water fluoridation.  Perhaps you can find a forum on dental amalgam somewhere else, let’s  but stay on topic here, okay?

 

Steven D. Slott, DDS

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Re: Fluoride - Demand AARP Take Action

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Message 1289 of 1,417

“CaryAnne”

 

Karen, do you seriously believe that a handful of unsubstantiated personal opinions constitutes valid evidence of anything, whatsoever?  

 

Sigh..... I will be glad to provide you with a page full of opinions to the contrary from some of the most highly respected healthcare professionals and organizations in the world if that’s your argument.

 

Steven D. Slott, DDS

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Message 1290 of 1,417

1.  No, Bill, I did not ask “for any peer-reviewed evidence fluoride at 0.7-1.4 ppm” whatever in the world you deem that to mean.

 

2.  The US DHHS did not lower anything, nor find anything unsafe, in regard to water  fluoridation.  These are yet more false claims to add to your ever growing list of such.

 

3.  A FAN claim as to what NHANES data has shown does  not constitute  proper evaluation of this data by any qualified, reliable entity.

 

4.  Yes, the 2006 NRC Committee on Fluoride in Drinking Water considered severe dental fluorosis to be an adverse effect.  This is of no relevance to optimally fluoridated water.  As this same committe clearly stated in its final report, severe dental fluorosis does not occur in communities with a water fluoride content below 2.0 ppm.  Water is fluoridated at 0.7 ppm, one third that level.

 

5.  Neither you, nor anyone else, has provided any valid, peer-reviewed scientific evidence that anyone, anywhere, is being “harmed by the addition of fluoride in public water”.  Your inexplicable unsubstantiated personal opinion to the contrary obviously does not qualify as such evidence.

 

Steven D. Slott, DDS

 

 

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